scholarly journals Nutritional Support Indications in Gastroesophageal Cancer Patients: From Perioperative to Palliative Systemic Therapy. A Comprehensive Review of the Last Decade

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2766
Author(s):  
Giulia E.G. Mulazzani ◽  
Francesca Corti ◽  
Serena Della Valle ◽  
Maria Di Bartolomeo
Keyword(s):  
Gastric Cancer ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Nutritional Support ◽  
Randomized Clinical Trials ◽  
Review Literature ◽  
Cross Sectional ◽  
Nutritional Interventions ◽  
Oncological Treatment ◽  
Gastric Cancer Patients

Gastric cancer treatments are rapidly evolving, leading to significant survival benefit. Recent evidence provided by clinical trials strongly encouraged the use of perioperative chemotherapy as standard treatment for the localized disease, whereas in the advanced disease setting, molecular characterization has improved patients’ selection for tailored therapeutic approaches, including molecular targeted therapy and immunotherapy. The role of nutritional therapy is widely recognized, with oncologic treatment’s tolerance and response being better in well-nourished patients. In this review, literature data on strategies or nutritional interventions will be critically examined, with particular regard to different treatment phases (perioperative, metastatic, and palliative settings), with the aim to draw practical indications for an adequate nutritional support of gastric cancer patients and provide an insight on future directions in nutritional strategies. We extensively analyzed the last 10 years of literature, in order to provide evidence that may fit current clinical practice both in terms of nutritional interventions and oncological treatment. Overall, 137 works were selected: 34 Randomized Clinical Trials (RCTs), 12 meta-analysis, 9 reviews, and the most relevant prospective, retrospective and cross-sectional studies in this setting. Eleven ongoing trials have been selected from clinicaltrial.gov as representative of current research. One limitation of our work lies in the heterogeneity of the described studies, in terms of sample size, study procedures, and both nutritional and clinical outcomes. Indeed, to date, there are no specific evidence-based guidelines in this fields, therefore we proposed a clinical algorithm with the aim to indicate an appropriate nutritional strategy for gastric cancer patients.

Predicting the Quality of Life in Patients with Gastrointestinal Cancers in Iranian Population

2016 ◽  
Vol 9 (1) ◽  
pp. 43
Author(s):  
Aliakbar Hajaghamohammadi ◽  
Somayeh Ahmadi Gooraji ◽  
Ali Zargar
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Cancer Patients ◽  
Study Data ◽  
Cross Sectional ◽  
Social And Emotional ◽  
Gi Cancers ◽  
Eortc Qlq ◽  
Gastric Cancer Patients

BACKGROUND: Evaluation of the quality of life (QoL) of cancer patients gives valuable information regarding the burden of disease, type of treatment and its side effects in studies on chronic diseases. In this study an attempt is made to predict the QoL of patients with gastrointestinal (GI) cancer.METHODS: In a cross sectional prospective study, data of 107 patients with GI cancers 58 male & 49 female with a mean age of 60.7±10.5 referred to a hospital from April 2009 to June 2015 were collected by using two standard questionnaires of EORTC-QLQ C30 and EORTC-QLQ-GINET 21. Data analysis was done using multivariate analysis of variance (MANOVA) and correlation test in soft wares of STATA and SPSS.16.RESULTS: Total QoL score was 50.7±24.6 in patients with gastrointestinal cancer which is almost optimal. Symptoms level was more in gastric cancer patients and their major complaints were constipation and diarrhea.  QoL of patients with GI cancers were more affected by the educational level and type of cancer (P<0.05).A high correlation of QoL was related to social and emotional domains (P<0.05). Mean score of QoL was more in males with colorectal cancer, educated and retired patients (P<0.05).CONCLUSION: the social and emotional support to patients with esophageal cancer and to reduce the level of symptoms in patients with gastric cancer due to complications of their diseases or treatment should be of consideration to improve their QoL.

scholarly journals Objective quantitation of EGFR protein levels using Quantitative Dot Blot (QDB) method for prognosis of gastric cancer patients

2021 ◽  
Author(s):  
Lei Xin ◽  
Fangrong Tang ◽  
Bo Song ◽  
Maozhou Yang ◽  
Jiandi Zhang
Keyword(s):  
Gastric Cancer ◽  
Lung Cancer ◽  
Overall Survival ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Cox Regression ◽  
Dot Blot ◽  
Protein Levels ◽  
Kaplan Meier ◽  
Gastric Cancer Patients

Background: One causing factor underlying failures of several clinical trials of anti-EGFR therapies is the lack of effective method to select patients overexpressing EGFR protein. Quantitative Dot Blot method (QDB) is proposed here to measure EGFR protein levels objectively and quantitatively. Its feasibility was evaluated for prognosis of overall survival (OS) of gastric cancer patients. Methods: FFPE slices of 2X5 microM from gastric and Lung cancer specimens were used to extract total tissue lysates for QDB measurement. Absolutely quantitated EGFR protein levels were used for Kaplan-Meier Overall Survival (OS) analysis of gastric cancer patients. Results: EGFR protein levels ranged from 0 to 772 pmole/g for gastric cancer specimens (n=246), and from 0 to 2695 pmole/g for lung cancer patients (n=81). Poor correlation was observed between quantitated EGFR levels and IHC scores with r=0.018, p=0.786 from Spearman correlation analysis. EGFR was identified as an independent negative prognostic biomarker for gastric patients only through absolute quantitation, with HR at 2.29 (95%CI:1.23-4.26, p=0.0089) from multivariate cox regression OS analysis. A cutoff of 207.7 pmole/g was proposed to stratify gastric cancer patients, with 5-year survival probability at 37% for those whose EGFR levels were above the cutoff, and at 64% those below the cutoff based on Kaplan-Meier OS analysis. p=0.0057 from Log Rank test. Conclusion: A QDB-based assay was developed for both gastric and Lung cancer specimens to measure EGFR protein levels absolutely, quantitatively and objectively. This assay should facilitate clinical trials aiming to evaluate anti-EGFR therapies retrospectively and prospectively.

WJOG10517G: a multicenter Phase II study of mFOLFOX6 in gastric cancer patients with severe peritoneal metastases

2020 ◽  
Vol 16 (20) ◽  
pp. 1417-1424
Author(s):  
Toshiki Masuishi ◽  
Takako Eguchi Nakajima ◽  
Kentaro Yamazaki ◽  
Shuichi Hironaka ◽  
Chiho Kudo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Oral Intake ◽  
Peritoneal Metastases ◽  
Modified Folfox6 ◽  
Gastric Cancer Patients ◽  
New Treatments

Gastric cancer patients with severe peritoneal metastases, defined as massive ascites and/or inadequate oral intake, have been excluded from clinical trials of new treatments due to poor prognosis and tumor-related complications, such as ileus. Based on the results of the JCOG1108/WJOG7312G study, their prognosis when treated with 5-fluorouracil/ l-leucovorin or 5-fluorouracil/ l-leucovorin plus paclitaxel remained extremely poor in this setting. Retrospective studies have shown the promising efficacy of the modified FOLFOX6 (mFOLFOX6) regimen, with improved ascites and oral intake. Therefore, we planned a Phase II study of mFOLFOX6 in gastric cancer patients with severe peritoneal metastases (jRCTs041180007). The primary end point is overall survival, with an exploratory analysis comparing the findings with those of the JCOG1108/WJOG7312G study using Bayes' theorem. Trial registration Identifier: jRCTs041180007 (jRCTs: the Japan Registry of Clinical Trials).

Global and regional geographical prevalence of depression in gastric cancer: a systematic review and meta-analysis

2020 ◽  
pp. bmjspcare-2019-002050 ◽  
Author(s):  
Mostafa Kouhestani ◽  
Hasan Ahmadi Gharaei ◽  
Mohammad Fararouei ◽  
Hasan Hosienpour Ghahremanloo ◽  
Reza Ghaiasvand ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Subgroup Analysis ◽  
Eastern Mediterranean ◽  
Random Effect ◽  
Significant Heterogeneity ◽  
Cross Sectional ◽  
Pooled Prevalence ◽  
Prevalence Of Depression ◽  
Gastric Cancer Patients

BackgroundSubstantial uncertainty exists about the prevalence of depression in patients with gastric cancer. We aimed to summarise the global and regional pooled prevalence of depression among patients with gastric cancer.MethodUp to February 2020, we searched PubMed/MEDLINE, Embase, Scopus, Web of science (ISI) and PsychINFO to identify published studies on the prevalence of depression among patients with gastric cancer. The study selection procedure was in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We estimated the prevalence of depression in gastric cancer patients using a random-effect pooled estimate analysis approach with subgroup analysis based on WHO regions, and methods of depression measurement.ResultsTotally, we retrieved 3781 studies from the previously mentioned databases, of which 18 (12 cross-sectional and 6 cohort studies in design) met the eligibility criteria, which were published from 2001 to 2017 in different regions. The total sample size of the included studied contained 4709 patients with gastric cancer, of which 1885 cases were diagnosed with depression. The pooled prevalence of depression among gastric cancer patients was 37%(95% CI: 26% to 48%). Subgroup analysis showed that the highest prevalence of depression was in Eastern Mediterranean (pooled prevalence=42%; 95% CI: 18% to 65%) followed by the Western Pacific region (pooled prevalence=40%;95% CI: 26% to 54%). The results indicated a significant heterogeneity (I2=98.8%,P<0.05).ConclusionOur findings indicated that depression is high among gastric cancer patients. The findings suggest health authorities to provide specially designed social and psychological supportive care services, including screening for depression, among such patients.PROSPERO registration numberCRD42020139836.

A phase II study to examine the effectiveness of nutritional support with elemental diet for stage II/III gastric cancer patients receiving adjuvant chemotherapy with S-1 (OGSG 1108).

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 98-98
Author(s):  
Junji Kawada ◽  
Hiroshi Imamura ◽  
Jin Matsuyama ◽  
Junichi Fukui ◽  
Kazuhiro Nishikawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Weight Loss ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Nutritional Support ◽  
Elemental Diet ◽  
Stage Ii ◽  
Postoperative Weight Loss ◽  
Second Stage ◽  
Gastric Cancer Patients

98 Background: Postoperative weight loss after gastrectomy causes deterioration in patient’s quality of life and tolerance for adjuvant chemotherapy in gastric cancer patients. Nutritional support may prevent postoperative weight loss and chemotherapy related adverse effects to improve compliance of adjuvant chemotherapy. Methods: Clinical stage II/III gastric cancer patients received R0 resection were registered in the first stage of the present study. Those patients were qualified and enrolled in the second stage who could intake more than 60% of elemental diet (Elental, 300 kcal/day for 14 days) in the postoperative period and were proven pathological stage II/III. Enrolled patients were planned to receive a total of 300 kcal/day of Elental for 24 weeks and additional courses was permitted up to 365 days. The primary endpoint was compliance of S-1: percent of patients who accomplish S-1 adjuvant for one year with more than 70% relative performance (RP). The secondary endpoints were nutritional parameters (body weight, BMI, s-albumin, s-protein, s-cholesterol), RP of 8 courses of S-1, adverse effects of S-1, RP of Elental and ratio of patients who were enrolled to the second stage. Results: From January 2012 to September 2014, 149 patients were registered in the first stage and 82 patients were enrolled in the second stage: including 50 men; 32 women; median age of 70 years (range, 42-85 years); and performance status were zero in 45 and one in 37 patients. Compliances of S-1 were 60.5% (95%CI: 49.0, 71.2) in 81 eligible patients and 69% (95%CI: 56.9, 79.5) in eligible patients without recurrence. In 81 eligible patients, RP of 8 courses of S-1 was 87.3 % (95%CI: 88.3, 85.9), and the body weight loss was 1.80kg (95%CI: -0.38, 4.48). Grade 3-4 toxicities were neutropenia 12%, anemia 4%, anorexia 4% and diarrhea 4%. Conclusions: Nutritional support for gastric cancer patients receiving adjuvant chemotherapy contributes to increase compliance of S-1 and potential effect on survival may be expected. Clinical trial information: UMIN000006872.

scholarly journals Central lymph node metastasis is predictive of survival in advanced gastric cancer patients treated with D2 lymphadenectomy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huiwen Lu ◽  
Bochao Zhao ◽  
Rui Huang ◽  
Yimeng Sun ◽  
Zirui Zhu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Advanced Gastric Cancer ◽  
Cancer Patients ◽  
Poor Prognosis ◽  
Randomized Clinical Trials ◽  
Central Lymph Node ◽  
N Stage ◽  
Central Lymph ◽  
Gastric Cancer Patients

Abstract Background The number of positive lymph nodes, which was defined as “N stage”, is mostly used to predict the survival of D2-resected gastric cancer patients, not the location. A “central lymph node” (CnLN) was defined by Ikoma et al., included common hepatic, celiac and proximal splenic artery LNs. CnLNs located in the extraperigastric area are included in the D2 LN station for gastric cancer. We speculate that CnLNs can be regarded as a predictor of survival. Methods Eligible advanced gastric cancer patients who underwent curative resection and D2 lymph node dissection between 2004 and 2012 at our institution were identified. The frequency of CnLN metastases and risk factors affecting DFS were examined. Survival differences were assessed by log-rank tests and Kaplan–Meier curves. Results The study identified 1178 patients who underwent curative surgery or D2 or more extensive lymphadenectomy. A total of 342 patients had been proven to have CnLN metastasis. Larger tumor size (P < 0.001), more frequent lymphatic vessel invasion (P < 0.001), signet ring cell histology (P = 0.014), and more advanced pathological T stage (P = 0.013) were significantly related to CnLNs metastasis. The patients with CnLN metastasis had a poor prognosis (HR for DFS of 1.366, 95%CI = 1.138–1.640, P = 0.001). For the pN2/3 patients, CnLN metastasis was associated with shorter 5-year DFS (for pN2 patients: 25.9% vs 39.3%, P = 0.017; for pN3 patients: 11.5% vs 23.4%, P = 0.005). Conclusion Gastric cancer patients with CnLN metastasis who underwent D2 resection had a poor prognosis. With the same N stage, the patients with positive CnLNs had shorter survival. CnLNs metastasis could be a supplement to N stage and a predictor of survival in gastric cancer patients. Large sample, multicenter, randomized clinical trials are still needed in the future.

Prevalence of Malnutrition Among Gastric Cancer Patients Undergoing Gastrectomy and Optimal Preoperative Nutritional Support for Preventing Surgical Site Infections

2015 ◽  
Vol 22 (S3) ◽  
pp. 778-785 ◽  
Author(s):  
Yasunari Fukuda ◽  
Kazuyoshi Yamamoto ◽  
Motohiro Hirao ◽  
Kazuhiro Nishikawa ◽  
Sakae Maeda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Nutritional Support ◽  
Surgical Site Infections ◽  
Gastric Cancer Patients
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